For those who spend their lives in the quiet intensity of a hospital ward or the controlled chaos of an emergency department, the risk of physical harm is often viewed as an occupational hazard—a regrettable but expected part of the job. However, a new analysis published in the New Zealand Medical Journal suggests that violence against healthcare workers is not just a series of isolated incidents, but a frequent, systemic issue that remains dangerously under-reported.
The research, authored by Wendy Strawbridge, Ruth Money and Lillian Ng, describes a workforce already stretched to its limits, where doctors and nurses are frequently assaulted while in a state of high vulnerability. The authors argue that the physical injuries are only the beginning; the subsequent lack of organizational support and a fragmented legal response often leave victims to navigate their recovery in isolation.
As a physician, I have seen how the “stoic” culture of medicine can inadvertently silence victims. When a clinician is assaulted, there is often an internal pressure to prioritize the patient—even the patient who committed the assault—over their own safety. This study brings that invisible struggle into the light, highlighting a critical gap between the safety protocols on paper and the lived experience of frontline staff.
The invisible psychological toll
While the emergency department (ED) remains the primary flashpoint for workplace violence, the study emphasizes that no department is entirely immune. The impact of these encounters extends far beyond the immediate physical trauma. The authors note that violence in the healthcare sector creates significant psychological and emotional consequences, which can lead to long-term impairments in a professional’s ability to function.
Anne Daniels, president of the New Zealand Nurses Organisation, noted that the significance of this research lies in its shift away from raw data toward the human experience. She pointed out that the “decimation of people’s personal lives” is a reality that numbers cannot fully capture, noting that many healthcare workers must essentially rebuild their careers and learn how to feel safe in their environment once again.
The study suggests that the recovery process is often a lonely one. Because the onus is frequently placed on the victim to follow up on reports and seek their own support, many fall through the cracks. The authors describe a desperate need for a culture of “self-care” backed by institutional mandates, recognizing that rehabilitation from workplace violence can be a prolonged process.
A ‘clunky’ intersection of health and justice
One of the most poignant critiques in the New Zealand Medical Journal article is the failure of the legal system to support healthcare victims. The authors describe the interface between “justice” and “health” as poorly intersected, characterized by a “clunky process” that drains the victim’s time and energy through excessive paperwork and bureaucratic hurdles.
This systemic friction often discourages workers from reporting assaults in the first place. When the process of seeking justice feels as exhausting as the assault itself, under-reporting becomes a survival mechanism. The authors argue that the rights of victims—to be informed of services, to understand their reactions to crime, and to feel a guaranteed sense of safety—can only be realized through well-constructed, streamlined processes that do not penalize the victim for seeking help.
Security investments versus root causes
In response to these findings, Health New Zealand has pointed to significant investments in physical security and staff training. Robyn Shearer, executive director of People & Culture and Health & Safety, stated that no level of violence is acceptable and that staff have a fundamental right to feel safe.
According to Shearer, there has been a $31 million boost to security specifically for emergency departments over the last two years. This funding has facilitated a “step change” in security provision across hospital campuses. Since January 2025, over 51,700 hours of training in de-escalation techniques have been delivered to 4,160 staff members, including doctors, nurses, and security personnel.
Shearer noted a paradoxical trend: while reported incidents have increased, the severity of injuries and the amount of time lost to injury have remained stable. From an administrative perspective, this suggests that earlier intervention and better de-escalation are working. However, this “stability” in injury rates does not necessarily erase the psychological trauma of the increased frequency of incidents.
This is where the perspectives of nursing leadership and health administration diverge. While Health NZ focuses on mitigation and response, Anne Daniels argues that the industry is missing the most critical question: Why is this happening? Daniels asserts that society needs comprehensive research into the root causes of violence in healthcare settings to stop the cycle entirely, rather than simply managing the aftermath with more security guards.
| Focus Area | Study Recommendations (Strawbridge et al.) | Current Health NZ Measures |
|---|---|---|
| Data & Reporting | Nationwide, unified approach to collecting and analyzing data. | Tracking reported incidents and time lost to injury. |
| Staff Protection | Strengthening legislation to clarify organizational responsibility. | $31 million investment in ED security; 24/7 hospital security. |
| Staff Support | Research into psychosocial impacts and long-term rehabilitation. | De-escalation training (51,700+ hours delivered). |
Disclaimer: This article is provided for informational purposes only and does not constitute legal or medical advice. Individuals experiencing workplace violence should consult with their professional union, legal counsel, or a licensed mental health professional.
For those struggling with the aftermath of workplace violence, support is available through the New Zealand Nurses Organisation (NZNO) and various employee assistance programs (EAP) provided by regional health boards.
The path forward requires a transition from reactive security to proactive prevention. While the $31 million investment in security provides a necessary shield, the call for research into the societal drivers of healthcare violence remains the next critical checkpoint. The healthcare community now awaits further commissioned research into the psychosocial impacts of these assaults to determine if current legislation is sufficient to protect those who provide care.
Do you work in healthcare? Have you experienced these systemic gaps in support? Share your thoughts in the comments or reach out to our editorial team.
